In conversation with Sarah Anderson

Wednesday, January 30, 2019

Respiratory Care Solutions (RCS) was established in 2015 by Melissa Canavan and Sarah Anderson who originally founded Leeds Respiratory Network in 2013 with the aim of educating practice nurses. Responding to the poor respiratory outcomes in Leeds shown in the Atlas of Variation, RCS wanted to try and reduce some of this variation through education. Over the past few years the network has grown to include all members of the multi-disciplinary team from pharmacists to prison nurses, school nurses to SALT’s. RCS now have members from primary, secondary and community care.

Welcome back to Respiratory Futures Melissa Canavan and Sarah Anderson. We last heard from you in 2017 when you had just secured a contract for your social enterprise Respiratory Care Solutions with 8 GP practices in Leeds.

How has that contract progressed?

The contract is going really well! It was originally for 12 months but has now been extended for a further 9 months, as the locality secured some extra funding. Originally the footprint was 8 GP practices but since September it has extended to 12 GP practices. Due to changing landscape of the NHS we have both ended up also being locality lead nurses in the new local care partnerships in Leeds. We have been lucky that we have been given a free reign to be as innovative and creative as we like. We have been working with the GP practices to provide updates, and sit in face to face joint clinics and virtual reviews. We have also been working with the wider community visiting community pharmacies to give updates and working closely with the schools. The locality lead nurse role has also opened up doors to work with the local council and third sector too so we have been able to hold patient information sessions in local community centres.

Our business model allows us to reinvest profits made back into developing people within the networks. Since 2015, we have paid for 9 HCP’s to attend the PCRS leadership event and 30 HCP’s to attend the PCRS annual conference.

One challenge has been trying to obtain data to allow us to monitor progress, we had originally planned to have baseline data for each practice but this was unobtainable so we have had to settle for locality level data. Trying to get follow up data has also been difficult due to staff and commissioning changes, and we were even sent some incorrect data.

We have been in touch with people working on diabetes in a different locality who have encountered the same problems. They have suggested we monitor progress on increased confidence of staff as an alternative to demonstrating harder outcomes where the data is not available.

You were also planning to set up a franchise model to support others around the country to set up respiratory networks. How widely have you been able to spread your model so far?

In 2016, we were approached by two Nurses in the Wakefield area to ask if we would help them set up a respiratory network. We had never met them before but we were more than happy to help. Leading on from this we have now been able to help Birmingham, Bedford and Hertfordshire set up respiratory networks. Harrogate will be coming on board at the start of 2019 and a few other areas are also interested. All of the networks sit under our social enterprise Respiratory Care Solutions.

Fantastic! And what support do you offer to these other networks?

When we initially set up our network it was quite difficult and time consuming: trying to organise venues, sponsorship and so on. Now we are an organisation we have an events organiser who arranges everything so that relieves a lot of pressure. We have an administration staff who deal with sponsorship, so the nurses don’t have to get involved with that side of things either. So, it is their network, they run it, choose the speakers and get people to turn up, everything else behind the scenes is taken care of.

Because we are a social enterprise, our business model allows us to reinvest profits made back into developing people within the networks. Since 2015, we have paid for 9 HCP’s to attend the PCRS leadership event and 30 HCP’s to attend the PCRS annual conference, with travel, accommodation and conference fees all paid for. We are really keen to develop as many people as possible and invest in the nurses to make them feel valued. We are building relationships with the leads of the networks, we have a whatsapp group for support of each other should we need it and we also had a Christmas night out together in Leeds so we could all get to know each other better.

We have been working with ... GP practices ... community pharmacies ... schools ... the local council and third sector.

That all sounds brilliant! One of the reasons you are interested in respiratory disease is because of the levels of healthcare inequalities in the field, and Leeds particularly has struggled in terms of respiratory outcomes. Do you think things have improved over recent years?

Things have improved at a strategic level, we have an integrated COPD service, with a hospital at home team. In Leeds there is now a respiratory steering group with different sub-groups focusing on different priorities. However we are now facing problems in primary care with staff shortages as lots of people are retiring and leaving. This is one of my main concerns for the future, I think it will have a big impact of respiratory outcomes and mean we will have to work differently. I would like to see all people looking after respiratory patients having the right knowledge and skills to do this.

We couldn't agree more, and on that note, what are your plans for the coming years?

We hope RCS will continue to grow! We would love to see RCS franchises around the country with both educational networks and social enterprises bidding for contracts. It’s quite concerning now that we have a situation where any willing provider is able to bid for contracts. We would like to see providers like ourselves who value the best interest of patients and staff over profit, running these contracts. We are passionate about valuing and developing staff that will hopefully lead to improved outcomes.